RESUMEN
The outlook for elimination of the scourge of cervical cancer is bright, because we now have the tools to achieve this goal. In recent years human papillomavirus (HPV) vaccination in high-income countries has resulted in dramatic decreases in HPV infection and associated cervical disease. If all countries with a substantial burden of disease introduce the vaccine nationally, we can protect the vast majority of women and girls most at risk. For women who are beyond the vaccination target age, progress has been made in screening and treatment for cervical precancer, but we must accelerate this momentum to reduce incidence and mortality worldwide to the very low rates found in wealthier countries. Human and financial resources must be increased and directed to programs that follow best practices and reach all women, including the marginalized or disadvantaged. Seven key actions are recommended. Now is the time for action at national, regional, and global levels.
Asunto(s)
Vacunación Masiva , Infecciones por Papillomavirus/prevención & control , Vacunas contra Papillomavirus/provisión & distribución , Neoplasias del Cuello Uterino/prevención & control , Femenino , Salud Global , Implementación de Plan de Salud , Humanos , Salud de la MujerAsunto(s)
Erradicación de la Enfermedad , Infecciones por VIH/transmisión , Transmisión Vertical de Enfermedad Infecciosa/prevención & control , Complicaciones Infecciosas del Embarazo/prevención & control , Sífilis/transmisión , Fármacos Anti-VIH/uso terapéutico , Femenino , Infecciones por VIH/prevención & control , Humanos , Embarazo , Atención Prenatal , Sífilis/prevención & control , Tailandia , Zidovudina/uso terapéuticoAsunto(s)
Democracia , Salud Global , Francia , Política de Salud , Derechos Humanos , Humanos , Cobertura Universal del Seguro de SaludAsunto(s)
Síndrome de Inmunodeficiencia Adquirida/prevención & control , Salud Global , Síndrome de Inmunodeficiencia Adquirida/economía , Síndrome de Inmunodeficiencia Adquirida/epidemiología , Síndrome de Inmunodeficiencia Adquirida/transmisión , Investigación Biomédica/métodos , Epidemias , Medicina Basada en la Evidencia/métodos , Costos de la Atención en Salud/estadística & datos numéricos , Humanos , Participación del PacienteRESUMEN
The women, men, and transgender people who sell sex globally have disproportionate risks and burdens of HIV in countries of low, middle, and high income, and in concentrated and generalised epidemic contexts. The greatest HIV burdens continue to be in African female sex workers. Worldwide, sex workers still face reduced access to needed HIV prevention, treatment, and care services. Legal environments, policies, police practices, absence of funding for research and HIV programmes, human rights violations, and stigma and discrimination continue to challenge sex workers' abilities to protect themselves, their families, and their sexual partners from HIV. These realities must change to realise the benefits of advances in HIV prevention and treatment and to achieve global control of the HIV pandemic. Effective combination prevention and treatment approaches are feasible, can be tailored for cultural competence, can be cost-saving, and can help to address the unmet needs of sex workers and their communities in ways that uphold their human rights. To address HIV in sex workers will need sustained community engagement and empowerment, continued research, political will, structural and policy reform, and innovative programmes. But such actions can and must be achieved for sex worker communities everywhere.